What happens after community-based screening for diabetes in rural and Indigenous individuals?

Rural individuals (mostly Indigenous) were screened for undiagnosed diabetes and cardiovascular risk. A subsequent survey showed roughly half engaged in timely follow-up with the health care system. The Mobile Diabetes Screening Initiative identifies a substantial number of people needing medical attention, who may otherwise be "missed" through conventional healthcare delivery.

Increasing rates of diabetes and cardiovascular risk in Métis Settlements in northern Alberta.

OBJECTIVES: To determine the prevalence of diabetes (using secondary data analysis), as well as undiagnosed diabetes and pre-diabetes (using primary research methods) among adult Métis Settlement dwellers in northern Alberta. We also sought to identify cardiovascular risk factors. STUDY DESIGN: Quantitative research study utilizing both population census and community-based diabetes screening data. METHODS: Self-reported diabetes was analyzed from the results of the Métis Settlement specific censuses in 1998 and 2006. Mobile clinics travelled into each of the 8 Métis Settlement communities in Alberta recruiting 693 subjects for screening for undiagnosed diabetes, pre-diabetes and metabolic syndrome. Logistic regression analyses (adjusted for age and sex) were used to identify associated factors. RESULTS: According to the censuses, 4,312 Métis individuals were living on Settlements in 1998 and 5,059 in 2006. Self-reported age-adjusted prevalence of diabetes increased significantly from 5.1% in 1998 to 6.9% in 2006 (p < 0.01), with a crude prevalence increase of 66% (p < 0.01). In 2006, diabetes prevalence was higher among females than males, 7.8% vs. 6.1% respectively (p < 0.05). Of the 266 adults screened in the fasting state, 5.3% had undiagnosed diabetes, whereas 20.3% (Canadian Diabetes Association criteria) and 51.9% (American Diabetes Association criteria) had pre-diabetes. Rates of obesity and metabolic syndrome were 49.4% (n = 693) and 46.4% (n = 266), respectively. Hemoglobin A1c > 6.1% was strongly associated with diabetes, pre-diabetes and metabolic syndrome. CONCLUSIONS: Our results indicate high rates of diabetes, undiagnosed diabetes, pre-diabetes and metabolic syndrome among adult Alberta Métis Settlement dwellers.

Assessment of diet quality in pregnant women using the Healthy Eating Index.

The objectives of this pilot study were to examine the diets of pregnant women and healthy women of childbearing age, to quantify their diets using the US Department of Agriculture Healthy Eating Index (HEI), and to assess the validity of the HEI in pregnancy in terms of macronutrients and micronutrients. Dietary information was prospectively collected from nonpregnant women and pregnant women at 20 to 38 weeks' gestation using 4-day food records. Diet records were analyzed for nutrient content using computer software and for overall quality using the HEI. Differences between the groups were analyzed statistically using the Student's t test, descriptive statistics, and chi 2 analysis. The macronutrient composition of the diets and the number of food group servings were similar in both groups. The HEI scores for control (nonpregnant) and pregnant women were similar, 72.6+/-1.52 and 75.0+/-0.99, respectively, of a maximum possible score of 100. Pregnant women did not meet daily recommended intakes of micronutrients of concern in pregnancy (calcium, iron, folate) through dietary means. Dietary counseling and nutritional supplements (particularly iron and folate) may be necessary. The HEI was useful in providing a composite measure of dietary intake, but did not discern the need for vitamin and mineral supplements during pregnancy.